Provider Demographics
NPI:1629217872
Name:SHARMA, VINOD (MD)
Entity type:Individual
Prefix:DR
First Name:VINOD
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VINOD
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1838 SQUIRREL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1146
Mailing Address - Country:US
Mailing Address - Phone:248-537-3012
Mailing Address - Fax:
Practice Address - Street 1:1838 SQUIRREL VALLEY DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-1146
Practice Address - Country:US
Practice Address - Phone:248-537-3012
Practice Address - Fax:248-537-3012
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIVS050478207Q00000X
MI4301050478208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine